The Center for Rural Addiction at the University of Vermont conducted interviews with 20 family members in rural Vermont to detail facilitators and barriers to using either medications for opioid use disorder (MOUD) or illicit opioids. The report highlighted some of the unmet needs that were discussed by family members of people in treatment. The University of Vermont Center on Rural Addiction is one of three Rural Centers of Excellence on Substance Use Disorders supported by the Federal Office of Rural Health Policy (FORHP).
National Pediatric Academy Releases Oral Health Report on Identifying Abuse and Neglect
The American Academy of Pediatrics (AAP) published a new clinical report, “Oral and Dental Aspects of Child Abuse and Neglect.” The report contains updated recommendations for physicians on how to identify problems involving a child’s teeth, gums, and mouth that may be signs of physical or sexual abuse or neglect.
57% of Rural Hospitals Lack Maternity Care: 19 States with the Biggest Gaps
From Becker’s Hospital Review
In the past five years, over 100 rural hospitals have stopped delivering babies, contributing to the 57% of rural U.S. hospitals that lack labor and delivery services.
This finding comes from the Center for Healthcare Quality and Payment Reform. Its July report details the number of rural hospitals by state that lack maternity care services, those that do offer such services, the financial losses incurred from maternity care and the travel time to the nearest hospital providing OB services.
“Over 80% of pregnancy-related deaths are preventable with appropriate prenatal, labor & delivery, and post-partum care,” the CHQPR report notes. “Although improvements in maternity care are needed in all parts of the country to reduce mortality rates, one of the greatest challenges is in rural areas, because most rural hospitals are no longer providing maternity care at all.”
Of the 978 rural hospitals that offer labor & delivery services, almost 40% lost money on patient services overall in 2022 through 2023, meaning their ability to continue delivering maternity care is at risk.
Below are the 19 states with the highest percentage of rural hospitals lacking OB or maternity care. In each of these states, the percentage of rural hospitals without OB care exceeds the U.S. average of 57%. There are ties below, resulting in 19 states with 12 rankings for the greatest proportion of hospitals without OB care.
Readers can find CHQPR’s report on maternity care deserts among rural hospitals in full here.
1. Florida
Total rural hospitals: 22
Number without OB services: 20
Percentage without OB services: 91%
2. North Dakota
Total rural hospitals: 39
Number without OB services: 31
Percentage without OB services: 79%
3. Louisiana
Total rural hospitals: 56
Number without OB services: 42
Percentage without OB services: 75%
4. Illinois
Total rural hospitals: 74
Number without OB services: 55
Percentage without OB services: 74%
West Virginia
Total rural hospitals: 31
Number without OB services: 23
Percentage without OB services: 74%
5. Nevada
Total rural hospitals: 14
Number without OB services: 10
Percentage without OB services: 71%
6. Virginia
Total rural hospitals: 30
Number without OB services: 21
Percentage without OB services: 70%
7. Alabama
Total rural hospitals: 52
Number without OB services: 36
Percentage without OB services: 69%
Oklahoma
Total rural hospitals: 81
Number without OB services: 56
Percentage without OB services: 69%
8. Mississippi
Total rural hospitals: 72
Number without OB services: 49
Percentage without OB services: 68%
9. Arkansas
Total rural hospitals: 50
Number without OB services: 32
Percentage without OB services: 64%
Georgia
Total rural hospitals: 72
Number without OB services: 46
Percentage without OB services: 64%
Montana
Total rural hospitals: 55
Number without OB services: 35
Percentage without OB services: 64%
10. South Dakota
Total rural hospitals: 49
Number without OB services: 31
Percentage without OB services: 63%
Pennsylvania
Total rural hospitals: 43
Number without OB services: 27
Percentage without OB services: 63%
11. Iowa
Total rural hospitals: 94
Number without OB services: 58
Percentage without OB services: 62%
12. Texas
Total rural hospitals: 164
Number without OB services: 97
Percentage without OB services: 59%
Kansas
Total rural hospitals: 100
Number without OB services: 59
Percentage without OB services: 59%
California
Total rural hospitals: 58
Number without OB services: 34
Percentage without OB services: 59%
Infant Mortality Increases
Infant mortality rose for the second consecutive year in 2022, with a 3% increase. The five leading causes of infant mortality remained the same as in 2021, including infant deaths due to maternal complications, which increased by 9%. This rise is linked to insufficient care in many states. Infant and maternal mortality rates in the US far exceed those of other high-income countries.
HHS Reports to Congress on Maternal Health Crisis
This report from the U.S. Department of Health & Human Services (HHS) cites research showing fewer than half of all rural counties have a practicing obstetrician and reports on federal efforts to improve maternal health outcomes, including rural-focused programs. See the full range of FORHP-supported research on rural maternal health at the Rural Health Research Gateway.
Perspectives on Opioid Use Disorder Treatment Access and Engagement from Rural Family Members and People in Treatment
Interviews with 20 family members in rural Vermont detail facilitators and barriers to using either medications for opioid use disorder (MOUD) or illicit opioids. The report comes from the University of Vermont Center on Rural Addiction, one of three FORHP-supported Rural Centers of Excellence on Substance Use Disorders.
Disability and Independence in Rural America: White Paper
The latest report from the National Advisory Committee on Rural Health and Human Services describes disability prevalence in rural areas and federal programs for people with disabilities. The paper outlines key considerations for rural disability services, including access, Medicaid and Medicare coverage, workforce, and telehealth and technology.
New White Paper Details Quality Improvement Through Swing Bed Utlization
Stroudwater has released a new brief detailing how Critical Access Hospitals (CAH) utilization of the swing bed program increased quality scores.
A CAH in southcentral Kentucky needed to improve its risk-adjusted mobility performance scores for its swing bed patients, and their rehabilitation and nursing staff needed to work as a team in motivating their swing bed patients to achieve their mobility goals, heal, and return home.
To learn how we helped this CAH improve its risk-adjusted mobility score by over 20%, please click here.
Recently, we published a white paper detailing how CAHs can enhance their role as providers of high-quality, community-centered care through proactive quality reporting and strategic use of data insights.
To read the full white paper, please click here.
CDC Publishes Collaborative Study on Alzheimer’s Disease, Related Dementia Diagnoses Among American Indian and Alaska Native Adults
The CDC recently released a collaborative study with the Indian Health Service (IHS), and the Alzheimer’s Association providing the first estimates of dementia among American Indian and Alaska Native (AI/AN) populations who receive health care services through IHS. This study was published in the Journal of the American Geriatrics Society.
The study found 14% of IHS patients diagnosed with Alzheimer’s disease and related dementias (ADRD) were early-onset cases (below age 65). However, globally, only 9% of dementia patients have early onset of the disease.
Because the study is limited to AI/AN adults who used IHS health care, the findings cannot be generalized to the entire AI/AN population. The researchers note the rates of Alzheimer’s disease may be underestimated due to AI/AN individuals with private insurance, Medicare or Medicaid, or another health plan are not reflected in the IHS data unless they received care at an IHS facility.
This study provides baseline data to help IHS, CDC, and other public health and tribal partners in addressing ADRD in AI/AN communities. The findings emphasize the need to implement ADRD risk reduction strategies, to screen and diagnose ADRD in younger populations, and to enhance clinical and community-based services to support AI/AN adults living with dementia and their caregivers.
As part of the National Healthy Brain Initiative (NHBI), CDC offers a Road Map tailored for AI/AN communities as they develop a broad response to ADRD. The Road Map is accompanied by a suite of resources to support AI/AN communities such as a planning guide, a dissemination guide, infographics, flyers and more.
New Brief Published: Changes in Rural Pharmacy Presence 2023
Fred Ullrich, BA; and Keith Mueller, PhD
This data brief continues the RUPRI Center’s series of reports exploring the availability of retail pharmacy services in rural areas of the U.S. It provides information on rural communities that have kept, lost, or gained a retail pharmacy between 2018 and 2023.
Read the full report here.
Additional products:
- Update on Rural Independently Owned Pharmacy Closures in the United States, 2003-2021
- Rural and Urban Pharmacy Presence – Pharmacy Deserts
For more information, contact
Keith J. Mueller, PhD; keith-mueller@uiowa.edu
Director, RUPRI Center for Rural Health Policy Analysis
University of Iowa College of Public Health